Zoning Certificate Application

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Application Use

Business or Industrial

Certificate of Exemption

Home Occupation

Residential

Sign Permit

Use Compliance

Note

New construction and additions require one complete set of construction drawings and sewage disposal system plans. Inspections must be requested by applicants.

Zoning District

PUD Number

Book

Page

Parcel

Location of Property

Lot Number

Subdivision

Name of Land Owner

Phone

Address

Occupant

Name of Contractor

Phone

Address

Proposed Use (Type)

Building Use

Building Information

Accessory Building

Addition

Deck

Fence

New Construction

Swimming Pool

Residence

Number of Bed Rooms

Number of Units

Other

Business

Industry

Sign

Size

Location of Sign

Owner Consent

Type

Construction Type

Use Class

Number Faces

Required plans shall be drawn to scale, showing the actual dimensions and shape the lot, exact sizes and locations of existing buildings on the lot, and the location and dimensions of the proposed buildings or alterations.

Type of lot

Corner

Cul-de-sac

Interior

Through

Main Road Frontage

Please give dimensions in feet by feet.

Depth of lot from right away

Please give dimensions in feet by feet.

Dimensions of building

Please give dimensions of the width and depth in feet.

Lot size

Please give dimensions in acres.

Highest point of building above the established grade

Please give answer in regards to front, rear, and height by definition.

Set back from side of road right of way

Please give dimensions in feet.

Minimum distance allowed set back from side of road right away

Please give dimensions in feet.

Side yard clearance

Please specify which side of the yard and give dimensions in feet.

Minimum side yard clearance

Please give dimensions in feet.

Rear yard clearance

Please give dimensions in feet.

Minimum rear yard clearance allowed

Please give dimensions in feet.

Structure design and area

Number of Stories

Basement?

Yes

No

Basement:

Finished

Unfinished

Lower level square footage:

Deck square footage:

Number of decks:

First floor square footage:

Garage square footage:

Car garage?

Yes

No

Second floor square footage:

Other square footage:

Off street parking?

Yes

No

Number of off street parking spaces?

Total square footage:

New sewage permit required?

Yes

No

Number

BZA approval required?

Yes

No

Case number

Remarks

Authority to make application

Surveyor certification required?

Yes

No

Date recieved

Date recieved

I hereby certify that all of the information supplied in this application and attachments hereto are true and correct to the best of my knowledge, information and belief. I hereby consent to the inspection of the subject property and of any buildings or structures to be constructed thereon by the township zoning inspector. I hereby acknowledge that I understand that if the construction or use described in the zoning certificate has not begun within six months from the date of issuance, said zoning certificate shall become null and void.

Applicant's signature

Date

Date

Date inspection called for:*

Date inspection called for:

Date inspected*

Date inspected

Upon the basis of your application the information contained within is made a part hereof the proposed usage and is found to be in accordance with the Township Zoning Resolution.